Individual
SHANNON AIKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CF-SLP
Contact information
Practice address
11230 WAPLES MILL RD STE 100, FAIRFAX, VA 22030-6087
(703) 591-1146
Mailing address
11230 WAPLES MILL RD STE 100, FAIRFAX, VA 22030-6087
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2204000312
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T69423466
—
VA
Enumeration date
08/22/2019
Last updated
08/22/2019
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